After hitting record lows around 2009, gonorrhea rates have been climbing steadily. Chlamydia and syphilis rates have also been increasing, hitting record national highs in 2016.

A likely culprit? Lack of early screening.

The 2008 recession led to severe budget cuts, which drastically affected state and local STD program budgets. In 2009, 34 states cut STD program funding. These cuts directly affected laboratory, clinical care and screening services, thus nearly removing affordable access for low-income individuals.

STD transmission and human sexual health are complex issues, and thus cannot be explained by one factor alone. But it is possible these budgets cuts contributed to the current predicament of increased rates.

From 2013 to 2014 alone, syphilis rates increased by 15 percent, gonorrhea by 5 percent and chlamydia by 2.5 percent.

From 2009 to 2011, the number of annual syphilis cases seemingly stagnated. But, from 2011 onward, the rate of increase in annual cases has been steeper than ever before — increasing by 43.4 percent from 2011 to 2014.

Though chlamydia rates appear to stagnate from 2011 to 2012, with a small dip in 2013, rates increased by 3 percent in 2014 — similar to the annual rates of increase in the 2001 to 2009 timeframe.

Perhaps most disheartening of all is the trend in gonorrhea rates. The United States started to see a real fall in annual gonorrhea cases from 2006 to 2009, but for the past seven years, the number of cases has been increasing. As of 2014, the U.S. is nearly back to early-2000 levels. Given that both chlamydia and gonorrhea often have no symptoms, without early screening, asymptomatic people who have been infected are much more likely to transmit the disease to future sexual partners.

Compounding the issue of the 2008 state budget cuts is the increasing federal debt. The lack of money nationwide is contributing to pressure to cut costs — but cutting STD program funding as a money-saving strategy could end up backfiring. The CDC estimates that STD cases “cost the U.S. health care system approximately $16 billion each year.”

According to Dr. Jonathan Mermin, director of CDC’s National Center for HIV/AIDs, Viral Hepatitis, STD, and TB Prevention, the CDC must “mobilize, rebuild and expand services — or the human and economic burden will continue to grow.”